Mucosal enzyme activity as a quantitative index of early functional improvement in the management of coeliac disease and other small intestinal diseases
Campbell, C.B.; Cowen, A.E.; McGeary, H.M.; Gaffney, T.J.
Australian and New Zealand Journal of Medicine 2(3): 220-227
1972
ISSN/ISBN: 0004-8291 PMID: 4508243 Document Number: 53739
In biopsy samples of jejunal tissue the ranges of activities of alkaline phosphatase, sucrase, lactase and maltase were similar in 6 healthy volunteers and in 28 patients with gastrointestinal symptoms not due to primary small intestinal disease. In the jejunal mucosa of 16 patients with coeliac disease activities of these enzymes, particularly lactase, were much reduced. After 6 to 14 weeks of treatment with a gluten-free diet, activities improved, though lactase was still generally rather low, and villous structure appeared to show only slight improvement. In 2 patients with giardiasis, activities were low, and, on treatment of 1 patient with metronidazole, increased to within the control ranges. Also in 1 patient with Whipple's disease with low enzyme activities, they increased to within the normal ranges during long-term treatment with tetracycline, before reduction in macrophage infiltration or changes in villous structure occurred.